Kilburn Netball Club

Full Name *(First and last name of player)

Date of birth *

Phone Number *Please provide the contact number for the person responsible for fees.

Address *

Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Email *Please provide the email address of the person responsible for fees.

Workplace/school

Age group *

Age groups are based on your age at 31/12/2022.11 and Under13 and Under15 and Under17 and Under21 and UnderGrade

Preferred positions *

You can choose more than one!GKGDWDCWAGAGS

Last year played and division *

For example, 2019 u13s div 2.

Do you need a clearance? *

A clearance is required if you have played at another STNA club in the past 3 years. NB: if you played at another club in 2020 only, you do not need a clearance.YesNo

If yes, from which club?

Are you or any family member interested in being involved in the following? (Or have special skills you'd like to contribute.)

The committee are always keen to hear from people who have ideas on how we can become the number 1 family focused club and to help us to implement them.UmpiringCoachingEventsFundraisingClub duty and/or game day assistancePhotographyGraphic DesignCatering etcOther (we'll be in touch)

Name *

Phone *

Relationship to you *

Name of doctor *

Doctor's phone *

Please detail any medical conditions, including allergies, that we should be aware of:

Action plan for medical conditions, include names of relevant medication you take:

Anything else we should know?

Photographic permission *

Throughout the season you may be photographed during training or matches by club personnel. We would like to be able to use these photos for promotional purposes such as in our newsletters, on this website and at the end of season dinner. Please let us know whether you would be happy with this or not.I give my consent for my photograph to be taken and used by the Kilburn Netball Club IncI DO NOT give my consent for my photograph to be taken and used by the Kilburn Netball Club Inc

Uniform Please make sure you order any uniform items you require at selections. Order forms will be available at each selection day and orders will only be accepted with a 50% deposit. The playing dress (or playing shirt) and shorts/pants are the only compulsory items of the uniform, all other items are optional.

Junior

Grade and 21s

Before selections

2022 Player Registration Form

Player history

Emergency contact

Medical details

Registration agreement

Verification

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